PERIPHERAL ULCERATIVE KERATITIS REVEALING AN ACTIVE HEPATITIS B INFECTION
Published 2025 - 29th ESCRS Winter Meeting
Reference: PO136 | Type: Presented Poster & Poster | DOI: 10.82333/5tg4-ew97
Authors: Atf Ben Abderrazek* 1 , fekih olfa 1 , anis mahjoub 1 , elyes jerbi 1 , imene zeghal 1
1Department A,Hedi rais institute of ophtalmology ,Tunis,Tunisia
Purpose
To illustrate the presentation of peripheral ulcerative keratitis (PUK) in a patient with underlying chronic hepatitis B virus (HBV) infection, emphasizing the importance of corneal findings and interdisciplinary management.
Setting
Institute of Ophtalmology, Hedi Rais Tunis, Department A
Methods
Clinical case
Results
A 47-year-old woman presented with redness, photophobia in the left eye. Best-corrected visual acuity (BCVA) was limited to 20/50 in the left eye. Anterior segment examination revealed, a severe pre-perforative peripheral ulcerative keratitis extended to the limbus without a clear interval of healthy cornea, with a descemetocele located at 5 o’clock. The right eye examination was unremarkable except for minimal dry eye syndrome.
Laboratory testing identified chronic active hepatitis B. The diagnosis of PUK revealing an active HBV was established. The patient received antiviral treatment for HBV, as well as topical therapy for the corneal ulcer, including lubricants (trehalose), prednisolone drops, and cyclosporine 0.5%. An oral corticosteroid therapy at 0.75 mg/kg was initiated, with gradual tapering as the ulcer improved by Day 21.
Conclusion
Early systemic treatment and targeted ocular therapy are critical in managing PUK to prevent serious visual outcomes. Beyond the visual risk, PUK can reveal severe, even life-threatening underlying conditions, such as hepatitis, underscoring the need for prompt and comprehensive systemic treatment.